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Search › Michigan › 225200000X

Matthew Prouty

NPI 1750010013 · on the registry since 2022 · sole proprietor

Practice

Address
2525 7th Ave S
Escanaba, MI 49829
Phone
(906) 786-0408
Organisation at this address
Christian Park Village Acquisition Company, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
6

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-06-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan